Evaluation & the Health Professions最新文献

The Low Back Activity Confidence Scale (LoBACS) is a 15-item scale designed to assess low back pain (LBP) through self-efficacy, a key predictor of functional recovery. This study aimed to culturally adapt and evaluate the validity and reliability of the Turkish version of LoBACS in patients with LBP. The translation and adaptation followed Beaton et al.'s protocol. Content and face validity were assessed with a pre-patient group. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to evaluate construct validity. Internal consistency, as well as test-retest reliability, were evaluated in a sample of 150 patients aged 18-70 years. Concurrent validity was measured alongside the Oswestry Back Pain Disability Questionnaire (ODQ) and Quebec Back Pain Disability Scale (QBPDS). Two factors emerged from factor analysis, with item loadings for Functional Self-efficacy (FnSE) ranging from 0.745 to 0.896 and for Self-Regulatory and Exercise Self-efficacy (Self-Reg&ExSE) from 0.817 to 0.940. Cronbach's alpha was high for FnSE, Self-Reg&ExSE, and the total scale (α = 0.941). Total correlation for each item ranged between 0.770 and 0.925. Test-retest reliability was also high (r = 0.941, p < .01). LoBACS showed moderate agreement with ODQ and QBPDS, demonstrating concurrent validity. In conclusion, the Turkish version of LoBACS is a valid and reliable tool for measuring LBP-related self-efficacy.

This study evaluated LLInC (Leerkracht-Leerling Interactie Coaching in Dutch, or Teacher Student Interaction Coaching), an intervention targeted at teachers' mental representations to improve dyadic teacher-child relationship quality. Four teachers and eight children from Dutch elementary schools participated in this single case study. Teachers themselves selected two children with whom they experienced a difficult relationship. The results indicated that teachers' global judgments of relationship quality improved from pretest to posttest for almost all teacher-child dyads. Day-to-day perceptions of conflict, closeness, and self-efficacy improved for a few teacher-child dyads, and especially for teacher-child dyads of the second targeted child. This implies that LLInC is especially helpful when carried out for at least two teacher-child dyads. The results of this study suggest that LLInC is promising, especially with regard to teachers' global relationship perceptions. However, LLInC should be further evaluated using a larger, representative sample, especially with regard to day-to-day perceptions of relationship quality.

Secure residential care (SRC) is criticized for several reasons. Therefore, in many countries, the general policy is to limit the length of stay of adolescents in SRC. However, research on length of stay and treatment effects of SRC on adolescents' behavioral problems is sparse. Using single case experimental designs with time-series, forty adolescents referred to SRC completed a questionnaire on behavioral and attention problems every two weeks during a baseline (A) and treatment period (B). Two-level regression analyses were used to investigate the effects of SRC on behavioral and attention problems. In addition, we tested whether length of stay moderated effectiveness. On the individual level, the treatment showed a positive statistically significant effect on the behavioral problems of 0%-8% of the adolescents and a statistically significant negative effect on behavioral problems was found in 3%-10% of the adolescents. On the group level, adolescents showed no significant decrease in problem behavior or attention problems from baseline to discharge. Length of stay did not moderate the results. Based on the results we conclude that most adolescents fail to improve. In addition, length of stay was not associated with effectiveness, nor could it be explained by adolescents' characteristics.

There are many ways proposed to achieve better societal outcomes (e.g., in health, education, and well-being) including: (1) bridging research and practice, (2) building the motivation and capacity of service delivery organizations (e.g., schools, hospitals, clinics, and community-based organizations) to innovate, and (c) providing service delivery systems with high-quality support via training and technical assistance. The Interactive Systems Framework for Dissemination and Implementation (ISF) was developed to describe how relevant systems, organizations, and processes can interact and work toward these goals. Stimulated by the 13 articles contained in the two special issues of Strengthening the Science and Practice of Implementation Support: Evaluating the Effectiveness of Training and Technical Assistance Centers, we describe several enhancements to the ISF including: how service delivery systems can operate better, how motivation and capacity can be built, and how training and technical assistance centers can provide more evidence-informed technical assistance and other promising innovations. ISF 2.0 incorporates these and other enhancements with the goal of achieving better outcomes. We conclude that the actions and accountability of funders and of organizations and systems to funders would accelerate progress in the systems to achieve outcomes-and result in improving the science and practice of implementation support.

Despite a growing body of research demonstrating the value of using evidence-based programs and practices (EBPPs) to address health and education issues, the gap between research evidence and practice in education and human services continues to be a vexing problem. Technical assistance (TA) is widely accepted as a key strategy to support evidence-based programs and practices (EBPP) uptake and implementation. However, little is known about how TA practices are used in TA delivery. Moreover, little attention has been paid to building the capacity of TA providers and assessing the fidelity of the implementation of TA practices. The case example presented in this article describes one organization's efforts to develop common language and definitions of TA services, core principles, and methods, and to standardize the delivery of TA by enhancing the capacity and retention of TA providers. We conclude with recommendations about how like organizations can employ similar efforts to improve the quality and consistency of TA delivery, thereby establishing a foundation for building a strong evidence base.

In low- and middle-income countries (LMICs), barriers such as low system readiness, contextual mismatches, and resource limitations impede effective implementation of evidence-based interventions. This commentary offers insights into overcoming these challenges with a case study of the PRISM project, designed to reduce behavioral and psychological symptoms of dementia in older adults living in Thailand. The case highlights how combining two evidence-based models - the Reducing Disability in Alzheimer's Disease clinical intervention and the Getting To Outcomes implementation science process enhances program success. Using interviews with stakeholders across various health system levels, we identify factors critical to successful program implementation: (1) integrating interventions into policy frameworks, (2) empowering local implementers, (3) fostering collaborative learning, and (4) adapting interventions to local contexts. The case demonstrates that building system readiness through local engagement and ownership is central to scaling up health programs in LMICs. This commentary's contribution lies in its emphasis on the role of implementation science as a vehicle for translating research into practice. It presents a practical, adaptive model for embedding interventions into routine health systems, thereby offering a pathway for successfully scaling up evidence-based programs in LMICs. Such findings provide lessons for overcoming barriers to implementation in resource-limited environments.

This article describes (a) key elements of a high-quality technical assistance (TA) system; (b) the operationalization of a high-quality TA system (Getting To Outcomes-Technical Assistance; GTO-TA) being implemented in a training and TA center (TTAC) interested in transforming its support services to include an evidence-informed approach to TA; and (c) key lessons learned in successfully transitioning from "TA-as-usual" to an evidence-informed TA system. GTO-TA is one operationalization of a systematic, proactive, evidence-informed approach to TA. GTO-TA includes best practices and core elements for a comprehensive TA system; it aims to increase the readiness (reduce barriers and increase facilitators) of an organization to deliver an innovation (program, policy, practice, and process new to an organization) with quality. We describe the collaboration between the Wandersman Center and the Geographic Health Equity Alliance team to co-design and implement the GTO-TA system. Data from surveys, interviews, and consensus conversations led to important lessons learned, which are applicable to other TTACs seeking to develop a more proactive and systematic approach to TA. Lessons include: changing internal operations to facilitate TA providers making necessary changes in providing TA and understanding the relative advantage perceptions about a new TA system that influence adoption and must be considered.

We introduce the second of two special issues that examine the science and practice of implementation support with takeaways for training and technical centers (TTACs). Major goals of both issues were to provide: rationale, concepts, and tools for evaluating training and technical assistance (TTA); an evidence-base for TTACs; and greater understanding of what is required to close the research-practice gap. To achieve these ambitious goals, we encouraged submissions from a broad array of individuals and groups involved in TTA. The seven articles in this second issue were written by a diverse mix of individuals affiliated with TTACs, federal agencies, research-oriented think tanks, and implementation scientists whose focus is on advancing the TTA literature. We felt that the collective wisdom garnered from their experiences would complement the first issue (June 2024) and collectively forge ahead and provide a vision of what is to come. We also thought it would be useful to provide perspectives on what it looks like when readers could examine both issues as a whole. Therefore, we included five commentaries-from the two editors and esteemed colleagues-who help provide a holistic perspective on the present and future of the science and practice of implementation support.

The benefits of training and technical assistance (TTA) have been well documented. There is limited literature that explores how complex systems of TTA are implemented and evaluated particularly in the violence prevention field. The Violence Prevention Practice and Translation Branch (VPPTB) within the Centers for Disease Control and Prevention's (CDC) Division of Violence Prevention funds multiple technical assistance providers who are tasked with building the capacity of program recipients to implement comprehensive approaches to prevent multiple forms of violence. VPPTB designed the Violence Prevention Technical Assistance Center (VPTAC) with the goal of implementing and evaluating comprehensive TTA efforts that integrates the work of multiple TTA providers to build the capacity of recipients to plan, implement, and evaluate violence prevention efforts. The VPTAC evaluation incorporates data from program recipients, TTA providers, and TTA modalities enabling the VPPTB staff to show improvement in technical knowledge, gather examples of enhanced implementation, and facilitate proactive TTA planning. An important step in the process of evaluating VPTAC from a system-level perspective required an expansion beyond evaluating a single TTA event, provider, or engagement. This is essential to understand how a diverse set of TTA activities and partners work together in their efforts to build capacity.

Technical assistance (TA) has long been a strategy utilized to support implementation of a range of different evidence-based interventions within clinical, community and other service settings. Great progress has come in extending the evidence base to support TA's use across multiple contexts, the result of more extensive categorizing of implementation strategies to support systematic studies of their effectiveness in facilitating successful implementation. This commentary builds on that progress to suggest several opportunities for future investigation and collaborative activity among researchers, practitioners, policymakers and other key decision-makers in hopes of continuing to build the success highlighted in this special issue and elsewhere. Authors call for increased attention to operationalization and tailoring of TA, considering how TA services can be sustained over time and how to consider externally-provided TA versus that housed within an organization. In addition, the commentary suggests a few key areas for capacity-building that can increase the quality, reach, and impact of TA for the future.